Auto-positive end-expiratory pressure and dynamic hyperinflation
Auto-positive end-expiratory pressure and dynamic hyperinflation
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DOI：
10.1016/s0272-5231(05)70322-1
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发表时间：
1996-09-01
影响因子：
5.7
通讯作者：
Giuliani, R
中科院分区：
文献类型：
--
作者：
Ranieri, VM;Grasso, S;Giuliani, R
呼气末肺容积偏离呼吸系统的弹性平衡容积被认为是严重慢性阻塞性肺疾病（COPD）和急性哮喘机械通气患者的主要特征。动态过度充气的存在意味着肺泡压力在整个呼气过程中保持为正。在呼气结束时，肺泡和外部气道压力之间的这种正差异被称为自动呼气末正压（PEEP）或内源性PEEP。本文的目的是：（1）回顾自动PEEP的生理机制和PEEP在抵消自动PEEP中的应用;（2）检查COPD患者PEEP应用的临床标准。
Deviation of end-expiratory lung volume from the elastic equilibrium volume of the respiratory system is recognized as a cardinal feature in mechanically ventilated patients with severe chronic obstructive pulmonary disease (COPD) and acute asthma. The presence of dynamic hyperinflation implies that alveolar pressure remains positive throughout expiration. At the end of the expiration, this positive difference between alveolar and external airway pressures is termed auto-positive end-expiratory pressure (PEEP) or intrinsic-PEEP. The aims of this article are (1) to review the physiologic mechanisms of auto-PEEP and the use of PEEP in counterbalancing auto-PEEP and (2) to examine the clinical criteria for application of PEEP in patients with COPD.